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P543 Assessment of Lactose Intolerance in Ulcerative Colitis Patients on Remission

E. AHISHALI*1, E.E. AKKUS2, C. DOLAPCIOGLU1, M. SAYINER2, T. ARSLAN2, R. YILMAZ3, A. KURAL1, R. DABAK2

1Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Gastroenterology, ISTANBUL, Turkey, 2Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Family Medicine, ISTANBUL, Turkey, 3Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Endocrinology, ISTANBUL, Turkey

Background

Lactose intolerance is a syndrome of symptoms caused by lactase deficiency, a condition that affects approximately 60% of the world's population. The symptoms of lactose intolerance are similar to those of inflammatory bowel disease, and hence patients with inflammatory bowel disease are known to be prone to make restriction of milk and dairy products in their diet. This study aims to determine the frequency of lactose intolerance and daily calcium intake from dairy products in ulcerative colitis patients on remission.

Methods

Eighty six ulcerative colitis patients who were on remission and had been followed up by our outpatient clinic were included in this study, and 92 healthy volunteers served as controls. Remission was assessed according to Clinical Activity Index. Patients and control subjects received 25 mg lactose following 8 hours of fasting and hydrogen breath test was performed with intermittent measurements. Intolerance was defined as >20 ppm increase in breath hydrogen concentration over baseline. Demographic characteristics of the patients and symptoms emerged during the test were recorded. A survey about patients' consumption rates of dairy products was filled and daily calcium intake was measured by a dietician.

Results

Mean age of the patients and the control subjects were 46.25 ± 12.44 and 44.79 ± 11.03 years, respectively. Fifty two of the patients (60.5%) and 49 of the healthy volunteers (53.3%) were male. There was no difference between the patients and the control subjects in terms of age and gender.

Lactose intolerance was significantly lower in patients compared to control subjects (p=0.01) with the intolerance being detected in 7 of the patients (8.1%) and 20 of the control subjects (21.7%). Twenty two of the patients (25.6%) and 20 of the healthy volunteers (21.7%) had gastrointestinal complaints related to hydrogen breath test but the difference was not statistically significant. None of the subjects in the patient and control groups developed systemic symptoms during the test.

Mean calcium intake from dairy products in patients (372.08 ± 279.73 mg/day) and control subjects (402.60 ± 249.47 mg/day) did not differ significantly.

Conclusion

To our knowledge, this is the first study in literature to report that patients with ulcerative colitis experience lactose intolerance less frequently than healthy volunteers, and the underlying pathophysiologic mechanisms of this observation need to be clarified. Besides, our data show that the daily calcium intake from dairy products in these patients lower slightly, though statistically insignificantly which may be in part due to the informing of the patients during regular follow-up.